Shiga-like Toxin-producing Escherichia coli O111 and Associated Hemolytic-uremic Syndrome: A Family Outbreak

• Published in: The Pediatric infectious disease journal Vol. 15; no. 11; pp. 1008 - 1011
• Main Authors: BANATVALA, NICHOLAS, DEBEUKELAER, MARTIN M, GRIFFIN, PATRICIA M, BARRETT, TIMOTHY J, GREENE, KATHERINE D, GREEN, JAMES H, WELLS, JOY G
• Format: Journal Article
• Language: English
• Published: Baltimore, MD Williams & Wilkins 01-11-1996; Philadelphia, PA Lippincott; Hagerstown, MD
• Subjects: Bacterial diseases; Bacterial diseases of the urinary system; Bacterial Toxins - analysis; Biological and medical sciences; Child, Preschool; Cluster Analysis; Enterotoxins - analysis; Escherichia coli; Escherichia coli - classification; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - diagnosis; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Feces - microbiology; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - epidemiology; Gastrointestinal Diseases - microbiology; Hemolytic-Uremic Syndrome - epidemiology; Hemolytic-Uremic Syndrome - microbiology; Human bacterial diseases; Humans; Infant; Infectious diseases; Male; Medical sciences; Serologic Tests; Serotyping; Shiga Toxins; Kidney disease; Human; Urinary system disease; Typing; Hemolytic uremic syndrome; Family study; Colibacillosis; Escherichia coli; Hemopathy; Epidemiology; Infection; Hemolytic anemia; Microbiological investigation; Renal failure; Bacteriosis; Bacteria; Enterobacteriaceae
• ISSN: 0891-3668; 1532-0987
• DOI: 10.1097/00006454-199611000-00015

OBJECTIVETo describe a family cluster of Shiga toxin-producing Escherichia coli O111:NM infection.
STUDY DESIGNThe index case was identified as part of a United States prospective study of hemolytic-uremic syndrome. Epidemiologic investigation was conducted through interviews. E. coli O111:NM infection was characterized through culture and serology. Shiga toxin 1 and 2 gene sequences were determined with oligonucleotide DNA probes.
RESULTSAll three children and both parents had nonbloody diarrhea, vomiting and abdominal cramps, and one child developed hemolyticuremic syndrome. Shiga toxin 1- and 2-producing E. coli O111ac:NM was isolated from two children. IgG antibodies to E. coli O111 were detected in all three children.
CONCLUSIONSTo our knowledge this is the first reported cluster of O111 infection and only the second caused by non-O157 Shiga toxin-producing E. coli in North America.